Prescribed Pediatric Extended Care (PPEC) centers allow Medicaid eligible children from birth through age 20 with medically-complex conditions to receive continual medical care in a non-residential setting. When approved, children can attend a PPEC up to a maximum of 12 hours per day while receiving nursing services, personal care, developmental therapies, and caregiver training.
Prescribed Pediatric Extended Care (PPEC) Provider Qualifications
To enroll as a Medicaid provider, a PPEC must be licensed pursuant to Chapter 400 Part VI, Florida Statutes, and be in compliance with Chapter 59A-13, Florida Administrative Code.
A PPEC located in Alabama or Georgia that regularly provides services to Florida Medicaid recipients may enroll as an in-state Florida Medicaid provider. All the enrollment requirements that apply to in-state providers apply to Georgia and Alabama providers, except the PPEC must have licenses and permits applicable to the state in which they are located.
Prior Authorization Vendor
The Agency for Health Care Administration (Agency) has entered into a contract with eQHealth Solutions, Inc. for utilization management, including prior authorization of PPEC services.
The primary purpose of the utilization management program is to safeguard against the provision of unnecessary medical services or inappropriate use of Medicaid services and to ensure appropriate care.
The Agency will provide periodic updates through the Florida Medicaid fiscal agent’s Web portal, provider bulletins, provider notification letters, and Medicaid Health Care Alerts.
For more information, please visit the eQHealth Solutions website.
Handbooks
Florida Medicaid handbooks furnish the Medicaid provider with the policies and procedures needed to receive reimbursement for covered services provided to eligible Florida Medicaid recipients.
The Medicaid Prescribed Pediatric Extended Care Centers Coverage and Limitations Handbook explains covered services and policies for the PPEC program.
The Medicaid Provider General Handbook contains requirements of the Florida Medicaid Program that apply to all providers. Providers must follow the provisions of this handbook in addition to their services specific handbook.
The Provider Reimbursement Handbook, CMS 1500 Handbook contains generic eligibility information, general Medicaid information, and claim instructions.
Florida Medicaid Health Care Alerts
Would you like Florida Medicaid Health Care Alerts sent directly to your email account? The Florida Medicaid program has an email alert system to supplement the present method of receiving Provider Alerts and to notify registered providers or interested parties of "late-breaking" information. An email will be delivered to your mailbox when Medicaid policy clarifications or other health care information is available that is appropriate for your selected provider type.
